Departments of Hematology and Oncology, Universitätsklinikum Giessen und Marburg GmbH, Marburg.
Departments of Hematology and Oncology, Vivantes Klinikum Am Urban, Berlin.
Ann Oncol. 2010 Apr;21(4):820-825. doi: 10.1093/annonc/mdp366. Epub 2009 Oct 11.
Survival after high-dose chemotherapy (HDCT) as second-salvage treatment (SST) in multiple relapsed germ-cell tumors (GCTs).
Existing databases in Berlin and Marburg of HDCT trials from 1989 to 2008 were retrospectively screened. Among 534 patients, 71 of 534 (13%) patients were scheduled for HDCT having failed previous conventional-dose first-line and first-salvage chemotherapy regimens; those 49 patients who had received at least cisplatin plus etoposide first-line as well as conventional-dose cisplatin-based first-salvage regimens and were diagnosed after 1 January 1990 were further analyzed.
Median age at SST was 32 years (range 19-52 years). Median follow-up for surviving patients was 4 years (range 1.7-8.5 years). Three of 49 (6%) patients either progressed or died before scheduled HDCT; the remaining 46 of 49 (94%) received either single or sequential HDCT. The rate of favorable responses to HDCT was 27 of 49 (55%). Nine patients remain alive and free of progression. One additional patient was lost to follow without progression at 4 years. The projected overall survival rate at 5 years was 17% (95% confidence intervals 7% to 30%).
HDCT can induce remissions in patients with multiple relapsed GCTs with a long-term survival rate of approximately 17%.
在多复发生殖细胞瘤（GCT）中，高剂量化疗（HDCT）作为二线挽救治疗（SST）的生存情况。
回顾性筛选了 1989 年至 2008 年柏林和马尔堡的 HDCT 试验的现有数据库。在 534 名患者中，534 名（13%）患者计划进行 HDCT，这些患者在先前的常规剂量一线和一线挽救化疗方案失败后；进一步分析了那些至少接受过顺铂加依托泊苷一线治疗以及常规剂量顺铂为基础的一线挽救方案，且在 1990 年 1 月 1 日后诊断出的 49 名患者。
SST 时的中位年龄为 32 岁（范围 19-52 岁）。对存活患者的中位随访时间为 4 年（范围 1.7-8.5 年）。在计划进行 HDCT 之前，有 3 名（6%）患者病情进展或死亡；其余 46 名（94%）患者接受了单次或序贯 HDCT。HDCT 的良好反应率为 49 例中的 27 例（55%）。9 名患者无进展且存活。另外 1 名患者在 4 年时无进展但失访。5 年总生存率预计为 17%（95%置信区间为 7%至 30%）。
HDCT 可诱导多复发 GCT 患者缓解，长期生存率约为 17%。
